UH00864 (9/07) Unity Health Plans Insurance Corporation (800) Unity Customer Service. unityhealth.com. Sauk City, WI 53583
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1 840 Carolina Street Sauk City, WI unityhealth.com Unity Customer Service (800) UH00864 (9/07) New Member Kit A guide to getting started
2 Welcome to Unity Health Insurance Topic Overview Online Information CONTACT US We re excited to have you as a new member. To help you, we ve created reference cards to guide you in using your health plan. Each card is made up of three sections: 1. Topic Overview 2. Online Information 3. Contact Information Take a moment to review each card. Keep this kit handy as a quick guide to answer your health insurance questions. Contact Us MAILING ADDRESS Unity Health Insurance 840 Carolina Street Sauk City, Wisconsin HOUR CALL BACK PROGRAM Call and leave a message or fill out an online form and we will return your call when itís convenient fo r you. UW HEALTH PATIENT RELATIONS If you would like help selecting a UW Health primary care physician, call UW Health Patient Resources at Monday through Friday, 7 a.m. to 5 p.m. Phone: customerservice@unityhealth.com Secure through Benefits Assistant For more information about self-service forms, go to unityhealth.com and click on Members. Here you will find the following information: PCP Change Form Address Change Form ID Card Request Form For questions, call Unity Customer Service at Contact Information
3 840 Carolina Street Sauk City, WI unityhealth.com Unity Customer Service (800) UH00865 (9/07) New Member Kit A guide to getting started
4 Welcome to Unity Health Insurance Topic Overview Online Information CONTACT US We re excited to have you as a new member. To help you, weõve created reference cards to guide you in using your health plan. Each card is made up of three sections: 1. Topic Overview 2. Online Information 3. Contact Information Take a moment to review each card. Keep this kit handy as a quick guide to answer your health insurance questions. Contact Us MAILING ADDRESS Unity Health Insurance 840 Carolina Street Sauk City, Wisconsin HOUR CALL BACK PROGRAM Call and leave a message or fill out an online form and we will return your call when it s convenient for you. UW HEALTH PATIENT RELATIONS If you would like help selecting a UW Health primary care physician, call UW Health Patient Resources at Monday through Friday, 7 a.m. to 5 p.m. Phone: customerservice@unityhealth.com Secure through Benefits Assistant For more information about self-service forms, go to unityhealth.com and click on Members. Here you will find the following information: PCP Change Form Address Change Form ID Card Request Form For questions, call Unity Customer Service at Contact Information
5 ACCESSING HEALTH CARE Accessing Health Care Find A Doctor provides information about your provider network as well as a search feature for participating practitioners and providers. Search by: primary care physician specialist location facility PPO members have different search features. See Find A Doctor for more information. Below is information on how to access care depending on your needs. TYPE OF CARE WHAT TO DO Routine care Contact your Primary Care Physician s (PCP) clinic After-hours care Contact your PCP clinic, they will tell you how to get appropriate care Urgent care Go to a participating urgent care center if your injury is not life-threatening but you need prompt attention Emergency care Go to the nearest hospital or call 911 Care away from home Contact your PCP clinic or if it s an emergency go directly to the nearest hospital Behavioral Health Care If your PCP is located in Dane County (excluding Black Earth and Cambridge), contact Behavioral Health Consultation System at for mental health services. For alcohol and other drug abuse (AODA) services, contact Gateway recovery at If your PCP is located outside of Dane County (including Black Earth and Cambridge), contact Behavioral Health Consultation System at For more information about your provider network, go to unityhealth.com and click on Find A Doctor. Here you will find the following information: Guidelines for your plan Participating practitioners and providers Also, make sure to click on Members then Member Guide to view information on: Accessing primary care Accessing specialty care Urgent and emergency care After-hours care Accessing care away from home Accessing behavioral health care For questions or printed materials, call Unity Customer Service at
6 GETTING STARTED Getting Started As a new member, we want to make it as easy as possible for you to start using your health plan so weve created a web page specifically for you. Here you will find all the information you need to know, including: For more information about getting started, go to unityhealth.com and click on New Member Kit. How to use your health plan How to access care Obtaining prescription medications (if applicable) Receiving rewards for staying healthy Managing your health Using A-Z Health Topics Here you will find all the information to help you make the most of your health plan. For questions or printed materials, call Unity Customer Service at or complete and return the enclosed postcard. As a new member, you will also receive a letter informing you about Benefits Assistant, our secure online tool, as well as providing you with a password to login. Write down your user ID and password here for future use. User ID Password
7 GETTING STARTED Getting Started As a new member, we want to make it as easy as possible for you to start using your health plan so we ve created a web page specifically for you. Here you will find all the information you need to know, including: For more information about getting started, go to unityhealth.com and click on New Member Kit. How to use your health plan How to access care Obtaining prescription medications Receiving rewards for staying healthy Managing your health Using A-Z Health Topics Here you will find all the information to help you make the most of your health plan. For questions or printed materials, call Unity Customer Service at or complete and return the enclosed postcard. As a new member, you will also receive a letter informing you about Benefits Assistant, our secure online tool, as well as providing you with a password to login. Write down your user ID and password here for future use. User ID Password
8 MANAGING YOUR HEALTH Managing Your Health Unity offers several programs to help you manage your health. The Preventive Health Care Guideline provides preventive service recommendations for infants, children, adolescents, adults and pregnant women. Unity s health management programs provide condition-specific education, resources and assistance for individuals with certain conditions. Asthma Diabetes Depression Chronic, situational or postpartum Materials members receive: Care Guidelines Educational mailings Reminders Helpful resources Condition specific newsletters For more information about managing your health, go to unityhealth.com and click on Fitness & Wellness. Here you will find information on: Asthma Diabetes (including the Active Living and Learning Program) Behavioral Health Tobacco Cessation Screening Tools Preventive Health Care Guideline For questions or printed materials, call Unity Customer Service at
9 Material Request Form First and Last Name Address City State Zip YES, I would like to receive the following printed materials: Provider Directory (A list of participating PCPs, specialists, and hospitals.) Certificate of Coverage (This document explains the benefits included under your Unity health insurance plan.) Three-Tier Prescription Drug Brochure (Information about your prescription drug benefits and Unity s formulary.) Prescription Drug Formulary (A list of formulary medications Unity believes are the most cost-effective.) Member Guide (Information about your health care benefits including routine medical care and much more.) Wellness Flyers (Information about Unity s family of wellness programs.) Preventive Health Care Guideline (This guideline promotes preventive health care services to keep you and your family healthy.) Notice of Privacy Practices (This Notice explains your rights, our legal duties, and our privacy practices.) UH00718 (9/07) To get printed copies of your member materials: Complete and mail back this card, or call Unity Customer Service at Please allow days for delivery.
10 Material Request Form First and Last Name Address City State Zip YES, I would like to receive the following printed materials: Provider Directory (A list of participating PCPs, specialists, and hospitals.) Member Guide (Information about your health care benefits including routine medical care and much more.) Wellness Flyers (Information about Unity s family of wellness programs.) Preventive Health Care Guideline (This guideline promotes preventive health care services to keep you and your family healthy.) Notice of Privacy Practices (This Notice explains your rights, our legal duties, and our privacy practices.) To get printed copies of your member materials: Complete and mail back this card, or call Unity Customer Service at Please allow days for delivery. UH00719 (9/07)
11 NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO. XXX SAUK CITY WI POSTAGE WILL BE PAID BY ADDRESSEE Unity Health Insurance 840 Carolina Street Sauk City, WI 53583
12 USING YOUR HEALTH PLAN Using Your Health Plan Here are a few key documents to help you use your health plan. UNITY JANE TEST UH12347 $10 OFFICE COPAY $50 ER $250 INPT DED $10/$20/$40 DRUG UW HLTH BEAVER DAM UMM Schedule of Benefits This document contains a summary of your benefits. Your Certificate of Coverage contains information about your plan including limitations and exclusions. ID Card Review your ID card to make sure your information is correct. Keep it in your wallet and show it each time you receive care. Explanation of Benefits Your explanation of benefits informs you of what Unity has paid and what you may owe after receiving care. For more information about using your health plan, go to unityhealth.com and click on Benefits Assistant. You will need to login by using your new ID and password sent in a separate letter. Here you will find the following information: Schedule of Benefits Certificate of Coverage Any applicable riders Claim information and authorizations Also, review your privacy rights by going to unityhealth.com and clicking on Privacy Practices. For questions or printed materials, call Unity Customer Service at
13 USING YOUR HEALTH PLAN Using Your Health Plan Here are a few key documents to help you use your health plan. UNITY JANE TEST UH12347 NO UNITY DRUG COVERAGE UW HLTH 20 S PARK 07 UWH It s Your Choice Book This document contains all of your benefit information. ID Card Review your ID card to make sure your information is correct. Keep it in your wallet and show it each time you receive care. Explanation of Benefits Your explanation of benefits informs you of what Unity has paid and what you may owe after receiving care. For more information about using your health plan, go to unityhealth.com and click on Benefits Assistant. You will need to login by using your new ID and password sent in a separate letter. Here you will find the following information: A link to the Department of Employee Trust Funds web site for all your benefit information Claim information and authorizations Also, review your privacy rights by going to unityhealth.com and clicking on Privacy Practices. For questions or printed materials, call Unity Customer Service at
14 REWARDS FOR STAYING HEALTHY Rewards for Staying Healthy Unity offers a variety of wellness programs to improve your overall health and well-being. Program Name Program Description Rewards Fitness First Exercise reward program for subscribers Choose between a $200 annual and their covered spouses cash reimbursement or prizes Fitness First for Kids Exercise reward program for Unity Prizes insured kids who are physically active Health First Discounts on health-related products Savings up to 66% and services Wellness First Reimbursement program for taking 50% of the cost of the class up to health-related classes at participating $50 per member per year hospitals and clinics Weight Watchers Reimbursement for attending 50% of first six months up Weight Watchers meetings to one-time payment of $130 Harbor Weight Loss Institute Comprehensive weight Two months free membership in management program health club; $400 upon completion Lifestyle Improvement through Reimbursement program for 50% of cost of program up to Nutrition and Exercise (LINE) taking a comprehensive lifestyle one-time payment of $130 or weight management program Integrative Medicine Reimbursement program for integrative Subscribers and covered spouses (Effective 1/1/08) medicine services each earn $50 annually Community Supported Reimbursement for purchasing a produce $50 for single coverage Agriculture share from a Madison Area Community or $100 family coverage (Effective 1/1/08) Supported Agriculture Coalition (MACSAC) farm For more information about rewards for staying healthy, go to unityhealth.com and click on Fitness & Wellness. Here you can: Learn more about these programs Enroll in the programs View prizes Lookup participating health clubs View a list of health-related classes For questions or printed materials, call Unity Customer Service at
15 PRESCRIPTION MEDICATIONS Prescription Medications Here are some steps to take if you have Unity drug coverage: Unity s Prescription Drug Formulary 1 2 Review the formulary to see if your current medication is covered and at what copayment. If your medication is not on the formulary, or is on the formulary but at a higher copayment, contact your practitioner to see if there is an alternative medication at a lower copayment. If your medication requires prior authorization for coverage, contact your 3 RX 90 Extended Supply Check to see if your medications, that are needed on a chronic basis and are at a stable dosage, qualify for a 90-day supply through Unity s RX 90 Extended Supply program by calling Free Home Delivery Receive free home delivery* when you practitioner to discuss alternatives that don t fill your prescriptions at a UW Health require authorization or have them submit pharmacy. Contact them for more prior authorization paperwork to Unity. information. Important phone numbers to call when you have questions WHEN TO CONTACT WHO TO CONTACT PHONE NUMBER To check the formulary status or restriction status of a drug Unity Customer Service To obtain a copy of Unity s Prescription Drug Formulary Unity Customer Service or unityhealth.com To appeal a Prior Authorization denial Unity Customer Service To speak to a clinical pharmacist about why a Unity Clinical Pharmacy Program Prior Authorization Request was denied For criteria for coverage of a medication Unity Clinical Pharmacy Program Early refills, vacation supplies, emergency supplies, Unity Pharmacy Services new member supply, reimbursement of medications purchased out-of-pocket *Delivery available in Fitchburg, Madison, Middleton, and Monona. For more information about prescription medications, go to unityhealth.com and click on Pharmacy Information. Here you will find the following information: Unity s Prescription Drug Formulary Three-Tier Pharmacy Benefit Brochure Pharmacy Lookup RX 90 Extended Supply Program For questions or printed materials, call Unity Customer Service at
16 PRESCRIPTION MEDICATIONS Prescription Medications As a participant in the State of Wisconsin health insurance program, your prescription medication coverage is through Navitus Health Solutions, LLC, a pharmacy benefit manager. You will receive an identification card directly from Navitus Health Solutions, LLC and you must use this when filling prescriptions. Local government participants, eligible for Medicare Part D, obtain pharmacy benefits from their selected Medicare Part D plan. Your Unity ID card should not be used for pharmacy benefits. For more information about prescription medications, go to navitus.com. Here you will learn more about your prescription drug benefits and pharmacy locations. CUSTOMER SERVICE For questions, call Navitus Health Solutions, LLC at
17 A-Z HEALTH TOPICS A-Z Health Topics The Healthwise Knowledgebase is an online encyclopedia that allows you to research symptoms, diagnoses, treatments and obtain helpful tips on self-care. Symptom Tracker allows you to find and learn about symptoms. For more information about Healthwise, go to unityhealth.com and click on A-Z Health Topics. Here you will find the following information: Health Topics Symptom Tracker Interactive Tools For questions, call Unity Customer Service at Interactive Tools help you manage different areas of your health.
18 CONTACT US Contact Us MAILING ADDRESS Unity Health Insurance 840 Carolina Street Sauk City, Wisconsin HOUR CALL BACK PROGRAM Call and leave a message or fill out an online form and we will return your call when it s convenient for you. UW HEALTH PATIENT RELATIONS If you would like help selecting a UW Health primary care physician, call UW Health Patient Resources at Monday through Friday, 7 a.m. to 5 p.m. Phone: For more information about self-service forms, go to unityhealth.com and click on Members. Here you will find the following information: PCP Change Form Address Change Form ID Card Request Form For questions, call Unity Customer Service at customerservice@unityhealth.com Secure through Benefits Assistant
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